Provider Demographics
NPI:1154716272
Name:IN HOME HOSPITAL CARE PA
Entity type:Organization
Organization Name:IN HOME HOSPITAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KYME
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLINTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-808-3690
Mailing Address - Street 1:501 ARVERN CT
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-6224
Mailing Address - Country:US
Mailing Address - Phone:407-682-2349
Mailing Address - Fax:407-332-9713
Practice Address - Street 1:501 ARVERN CT
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6224
Practice Address - Country:US
Practice Address - Phone:407-682-2349
Practice Address - Fax:407-332-9713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1265429047Medicaid